Organization
SOUTHEASTERN PSYCHOLOGICAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LINDA OLIVER-LINK (ADMINISTRATIVE DIRECTOR)
(910) 682-6718
Entity
Organization
Contact information
Practice address
302 N MAIN ST, FAIRMONT, NC 28340-1730
(910) 628-6718
(910) 628-6719
Mailing address
302 N MAIN ST, PO BOX 369, FAIRMONT, NC 28340-1730
(910) 628-6718
(910) 628-6719
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0384M
BCBS
NC
01
—
1318H
BCBS
NC
05
—
6005435
—
NC
Enumeration date
07/29/2005
Last updated
07/21/2022
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